Reflections on Secondary Care

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Holly Perfect-Porter looks into some of the common concerns heard from secondary care staff.

Working closely with NHS Healthcare systems has allowed us to hear staff members’ reflections and fears around the national drivers for improvement on a daily, and sometimes hourly, basis.

With a strong focus in the national press on delays at the ‘front door’ emergency care access, it becomes a challenge for managers and leaders of any department to ensure that their ‘part of the ship’ is running smoothly and efficiently. The focus for many becomes throughput; seeing as many patients as possible to clear backlogs in outpatients and free-up beds. Leading in uncertain times is certainly not for the faint-hearted and many leaders report feeling isolated and alone. Internal change projects can also be difficult to deliver and even harder to sustain long term. Our team recognises this difficult position and has a wealth of expertise in guiding managers through complex improvement programmes and supporting them with complicated internal processes. My advice would be - don’t go it alone! Analysing and interpreting National Data is important but recognising how that relates to the department and pinpointing the area for improvement, is even harder.

As I reflect on some of the concerns heard from clinicians and leaders, I recognise the themes and am reassured and comforted by the Xytal methodology to service change and improvement. The Xytal 5-step approach is a tried and tested improvement approach and really allows the department or team to achieve success. Only last week, I was part of a national meeting where we reflected on the lack of data collected which would have clearly demonstrated measurable benefits, and success and validated the case of change. The Xytal approach will provide a simple process to measure for improvement, capturing the right data and analysing it to demonstrate the story. Understanding what the data tells, and what it doesn’t, is a key part of any successfully sustained improvement activity. Sustained success will depend on the engagement of both clinicians and managers, this is shown in the data.

The recent update on the Xytal Radiology programme highlights how the Xytal 5-step approach can assist one, core team, which is part of the bigger system. The key to this program, and others using the Xytal 5-step approach, is that they enable departments to reduce unwanted variation, simplify processes, and improve patient flow. By communicating and collaborating with outpatients, theatres, wards, and other departments within the system, and working together to achieve fully integrated care pathways, we can align all the moving parts, complimenting each other and smoothing patient flow through the system, reducing bottlenecks and backlogs. Whole system thinking is not a new phenomenon, but those words add a layer of complexity to relatively achievable projects. Leaders often believe that a whole system approach will come from above, it doesn’t. A whole system approach requires each cog in the machine to work on their own identified projects, make sustainable improvements, and share the success and benefits with their neighbouring departments in the system (encouraging others to do the same along the way). Whole system approach to patient flow is knowing the end-to-end pathway and navigating services from a patient perspective and remembering there are access points in health care before the ‘front door’. Our consultants have an extraordinary amount of experience in primary and community care and care navigation.

Using this approach has guided me as a manager to deliver successful projects and demonstrate clear benefit realisation across several NHS and Healthcare provider departments, outpatients, wards, and theatres. The Xytal 5-step approach to improvement can be scaled from a single condition-specific team or function to a whole patient flow project across an organisation and full integration with provider collaboratives.

Over the last ten years that I have been working in the Healthcare Improvement arena, there have been varied drivers for improvement - with the reduction in cost always measured, even if not the primary driver for improvement. I believe there is a real shift in the tide from a clinical perspective. An ever-growing voice questioning the quality-of-care factors and voicing real everyday concerns with challenges in delivering safe services is making it ever easier to visualise a burning platform. The time is now, let’s start a conversation.

Xytal is one of the leading British consultancies in the health sector. If you found this article beneficial, you might also consider checking out our Radiology Support Programme.

Working closely with NHS Healthcare systems has allowed us to hear staff members’ reflections and fears around the national drivers for improvement on a daily, and sometimes hourly, basis.